NCLEX · Grief, Loss, and End-of-Life

A client with terminal illness says, 'If I can just make it to my daughter's wedding next month, then I'll be at peace.' According to Kübler-Ross, which stage of grief does this represent?

Correct answer

Bargaining — negotiating with God, fate, or medical providers for more time in exchange for something; the 'if-then' structure is characteristic

  1. A Bargaining — negotiating with God, fate, or medical providers for more time in exchange for something; the 'if-then' structure is characteristic
  2. B Acceptance
  3. C Depression
  4. D Anger

Why this is the answer

BARGAINING is the third stage in Kübler-Ross's model, characterized by attempts to negotiate for more time, better outcomes, or a specific delay to the inevitable. The structure is typically 'if-then': 'If I can just see my daughter get married, then I'll accept this.' 'If I follow every treatment protocol, maybe the doctors can give me more time.'

Therapeutic approach: Validate the wish and the meaning behind it (the wedding, the relationship); do not dismiss as denial or irrational; it often reflects what the client values and what gives life meaning; help the client plan for the event if medically feasible; gently explore what 'being at peace' means to them — this opens conversation about advance care planning and legacy.

The stages are not linear: People move among stages, skip stages, and return to earlier stages; some people never reach acceptance; this model is a framework for understanding, not a prescription.

Bargaining in families: Family members also bargain — 'if we try one more treatment'; this can sometimes delay comfort care unnecessarily; the palliative care team can help families balance hope with realistic planning.

Pn role: Meet the client where they are emotionally; support the meaning behind their request; coordinate with the care team about feasibility; document emotional state and coping.

Source: NCLEX-PN Test Plan: Psychosocial — Grief, Kübler-Ross Bargaining

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About this topic: Grief, Loss, and End-of-Life

Grief, loss and end-of-life questions cover stages and types of grief, supporting a dying client and family, comfort care, advance directives and the nurse's own responses to loss. This is one of 13 PN: Psychosocial Integrity questions on grief, loss, and end-of-life, each with a full explanation on a single study page.

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